Most of us have experienced pain in the lower calf muscle, heel, or ankle. This can be Achilles Tendinitis. The Achilles tendon is a large tendon connecting calf muscles to the back of the heel bone. The pain occurs due to irritation or inflammation in the tendon. It so happens when for some reason we put too much stress which causes tightening of the tendon making the tendon work too hard to perform the regular task. If we force our self to work through the pain, it can cause a tear or rupture. The rupture will generally occur on one side and is called Achilles heel injury.
Anatomy of Achilles tendon
Tendon is a tissue that connects a muscle with a bone. It generally has a very limited or no blood supply. The Achilles tendon is a tough band of fibrous tissues that connects calf muscles to the heel. There are small sacs of fluid called ‘Bursae’ which cushion the Achilles tendon at the heel. It is the largest and strongest tendon in the body. This tendon stabilizes our movements such as walking, running, or jumping. Despite being strongest, it is vulnerable to injuries.
Symptoms of Achilles Tendinitis
- Dull or sharp pain anywhere on the tendon but mostly towards the heel.
- Limited ankle mobility
- Feeling warm or burning sensation in the tendon area
- A lump that can be felt on the tendon
- Crackling sound with pain when ankle is moved
Common causes of Achilles tendinitis
- Tight calf muscles with limited flexibility and mobility
- Fatigued calf muscles
- Increase running or walking mileage too quickly.
- Over-training without giving adequate rest to muscles
- Hill running/ walking, climbing stairs,
- Spadework ( walking, running , jumping)
- Jumping harshly with load on toes repeatedly especially on hard surface
- Stiff shoes
- Over-pronating runners may get it over a period of time
Remember that if you have pain in the Achilles area, immediately stop the activity. If the activity is carried out in pain, it will soon lead to a tear or rupture. One must introspect the activity which might have caused it. Most important, ‘Never run in pain’.
Treatment of Achilles Tendinitis
- Apply ice for 15 to 20 minutes at least 3 to 4 times a day. This will reduce inflammation.
- NSAID (anti- inflammatory) medicine may help however remember that since the blood supply in the tendon is limited, the results from medicine will be slow.
- A light massage in the direction from top calf towards the heel can be performed. Do not be hard when you message as that may further irritate the tendon.
- Feel the tendon with your hand. If you find a lump anywhere in the tendon region, you must immediately consult a doctor.
- Treatment other than lump should respond in two to three weeks. In case pain remains at same level, you will have to consult a physician. However, if the pain has reduced but not fully cured, extend your treatment for one or two weeks.
Action after getting better
Once you are better and want to restart your activity, be sure that you have addressed the root cause. Some basic things that one must do so that it doesn’t reoccur are mentioned below:
- Strengthen the muscles of calves and feet by several exercises. (We will release the video on the exercises in coming blogs).
- Increase mobility of the ankle.
- Stretching calves is the most important thing which one must do before starting to run/ walk.
- Build the muscles and increase flexibility.
- Wear correct shoes. If you pronate, wear shoes which correct it the best.
- Do not increase your mileage or speed too quickly. Increase it slowly (no faster than 10% per week)
- Make a training program in which you include exercises for foot and calf muscles.
- Avoid heel strike. This you can do by reducing stride length and increasing cadence.
- Always include rest in your training program.